Department of Respiratory Medicine, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, 210008 Jiangsu, China.
Department of Respiratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China.
Dis Markers. 2019 Nov 11;2019:9709531. doi: 10.1155/2019/9709531. eCollection 2019.
Several serum markers were reported to reflect the severity of pulmonary alveolar proteinosis (PAP). The aim of this study is to investigate a reliable and facile marker to access and monitor the clinical course of PAP in a large cohort.
PAP patients from January 2010 to June 2018 were enrolled. Hospital records were used as data sources. The levels of various serum indicators were detected. We evaluated the correlation between pulmonary function test results and clinical variables.
Diffusion capacity for carbon monoxide (DLCO) level was positively correlated with the level of high-density lipoprotein cholesterol (HDL-C) ( < 0.05) in 122 patients of PAP at baseline. The levels of HDL-C and DLCO significantly increased while carcinoembryonic antigen (CEA), CYFRA21-1, neuron-specific enolase (NSE), and lactic dehydrogenase (LDH) levels decreased six months after granulocyte-macrophage colony-stimulating factor (GM-CSF) inhalation therapy between 14 patients with PAP. Nevertheless, the increased DLCO was significantly correlated with decreased CEA ( = -0.579, = 0.031) and CYFRA 21-1 ( = -0.632, = 0.015). In 10 PAP patients without GM-CSF inhalation therapy, HDL-C and DLCO significantly decreased while NSE and LDH levels increased after six months of follow-up. The decreased DLCO was significantly correlated with increased LDH ( = -0.694, = 0.026).
Serum CEA, CYFRA21-1, and LDH are valuable serum markers for the evaluation of disease activity of PAP and may predict the response to treatment of PAP.
有几种血清标志物被报道可反映肺泡蛋白沉积症（PAP）的严重程度。本研究旨在探索一种可靠且简便的标志物，以评估大量患者队列中 PAP 的临床病程。
纳入 2010 年 1 月至 2018 年 6 月的 PAP 患者。使用医院记录作为数据来源。检测各种血清指标的水平。我们评估了肺功能检查结果与临床变量之间的相关性。
在 122 例 PAP 患者的基线水平中，一氧化碳弥散量（DLCO）水平与高密度脂蛋白胆固醇（HDL-C）水平呈正相关（<0.05）。在 14 例接受粒细胞-巨噬细胞集落刺激因子（GM-CSF）吸入治疗的 PAP 患者中，治疗 6 个月后，HDL-C 和 DLCO 水平显著升高，而癌胚抗原（CEA）、细胞角蛋白 19 片段（CYFRA21-1）、神经元特异性烯醇化酶（NSE）和乳酸脱氢酶（LDH）水平下降。然而，增加的 DLCO 与降低的 CEA（=−0.579，=0.031）和 CYFRA21-1（=−0.632，=0.015）显著相关。在 10 例未接受 GM-CSF 吸入治疗的 PAP 患者中，随访 6 个月后，HDL-C 和 DLCO 水平显著降低，而 NSE 和 LDH 水平升高。降低的 DLCO 与升高的 LDH 显著相关（=−0.694，=0.026）。
血清 CEA、CYFRA21-1 和 LDH 是评估 PAP 疾病活动的有价值的血清标志物，可能预测 PAP 的治疗反应。
